BACKGROUND: Despite its rare incidence, few cases of left-side gallbladder have been already published. METHODS: We reported herein the case of a 29-year-old man with a left liver tumor in whom left lateral bisegmen- ...BACKGROUND: Despite its rare incidence, few cases of left-side gallbladder have been already published. METHODS: We reported herein the case of a 29-year-old man with a left liver tumor in whom left lateral bisegmen- tectomy was mandatory. It represents the first description of a sinistroposition of both gallbladder and common bile duct. RESULTS: Surgical exploration revealed a left-side gall- bladder , located under the left lobe of the liver. During he- patic parenchyma dissection at the left side of the round liga- ment and the Rex recessus, the common bile duct was in- jured. Complete separation of hepatic pedicle structures showed that the upper biliary convergence passed on the left side of the Rex recessus before reaching the hepatoduo- denal ligament. CONCLUSION: Only careful dissection of the hepatoduo- denal ligament up to Rex recessus level prior to liver paren- chyma resection could avoid biliary tract injury during left lobectomy.展开更多
During liver resection clamping of the hepato-duodenal ligament (the Pringle maneuver) is performed to reduce intraoperative blood-loss. During this maneuver acute portal hypertension may lead to spontaneous splenic r...During liver resection clamping of the hepato-duodenal ligament (the Pringle maneuver) is performed to reduce intraoperative blood-loss. During this maneuver acute portal hypertension may lead to spontaneous splenic rupture requiring rapid splenectomy in order to control blood loss. We present 2 case of patients with hemorrhage from the spleen during clamping for liver surgery. A review of the literature with an emphasis on the pathophysiology of splenic hemorrhage is presented.展开更多
目的对比分析外科肝胆手术患者术后应用常规保肝支持与给予肠内营养支持后患者的营养状态情况。方法随机选取2014年1月~2015年3月期间在我院肝胆外科手术治疗的120例患者作为研究对象,采取奇偶数随机分组的原则,分为实验组和对照组,每...目的对比分析外科肝胆手术患者术后应用常规保肝支持与给予肠内营养支持后患者的营养状态情况。方法随机选取2014年1月~2015年3月期间在我院肝胆外科手术治疗的120例患者作为研究对象,采取奇偶数随机分组的原则,分为实验组和对照组,每组均为60例。对照组采用每天静脉注射1750~1950 kcal的热量等常规营养支持的方法,实验组采用每500 m L提供的能量为480 kcal肠内营养制剂作为营养支持的方法,分别收集每位患者术前、术后第3天、术后第7天三个时间点的血糖、血清白蛋白以及血清胆固醇的水平。分析实验组和对照组研究对象上述指标的差异。结果两组术前血糖、血清白蛋白以及血清胆固醇的水平差异无统计学意义（P〉0.05）,术后第3天和术后第7天,实验组患者在血糖、血清白蛋白以及血清胆固醇的水平均明显高于对照组（P〈0.05）。实验组不良反应的发生率明显低于对照组（χ^2=8.961,P=0.022）。结论对于外科肝胆手术患者,给予肠内营养支持能明显改善患者的营养状态,有助于伤口的愈合和疾病的恢复。展开更多
文摘BACKGROUND: Despite its rare incidence, few cases of left-side gallbladder have been already published. METHODS: We reported herein the case of a 29-year-old man with a left liver tumor in whom left lateral bisegmen- tectomy was mandatory. It represents the first description of a sinistroposition of both gallbladder and common bile duct. RESULTS: Surgical exploration revealed a left-side gall- bladder , located under the left lobe of the liver. During he- patic parenchyma dissection at the left side of the round liga- ment and the Rex recessus, the common bile duct was in- jured. Complete separation of hepatic pedicle structures showed that the upper biliary convergence passed on the left side of the Rex recessus before reaching the hepatoduo- denal ligament. CONCLUSION: Only careful dissection of the hepatoduo- denal ligament up to Rex recessus level prior to liver paren- chyma resection could avoid biliary tract injury during left lobectomy.
文摘During liver resection clamping of the hepato-duodenal ligament (the Pringle maneuver) is performed to reduce intraoperative blood-loss. During this maneuver acute portal hypertension may lead to spontaneous splenic rupture requiring rapid splenectomy in order to control blood loss. We present 2 case of patients with hemorrhage from the spleen during clamping for liver surgery. A review of the literature with an emphasis on the pathophysiology of splenic hemorrhage is presented.
文摘目的对比分析外科肝胆手术患者术后应用常规保肝支持与给予肠内营养支持后患者的营养状态情况。方法随机选取2014年1月~2015年3月期间在我院肝胆外科手术治疗的120例患者作为研究对象,采取奇偶数随机分组的原则,分为实验组和对照组,每组均为60例。对照组采用每天静脉注射1750~1950 kcal的热量等常规营养支持的方法,实验组采用每500 m L提供的能量为480 kcal肠内营养制剂作为营养支持的方法,分别收集每位患者术前、术后第3天、术后第7天三个时间点的血糖、血清白蛋白以及血清胆固醇的水平。分析实验组和对照组研究对象上述指标的差异。结果两组术前血糖、血清白蛋白以及血清胆固醇的水平差异无统计学意义（P〉0.05）,术后第3天和术后第7天,实验组患者在血糖、血清白蛋白以及血清胆固醇的水平均明显高于对照组（P〈0.05）。实验组不良反应的发生率明显低于对照组（χ^2=8.961,P=0.022）。结论对于外科肝胆手术患者,给予肠内营养支持能明显改善患者的营养状态,有助于伤口的愈合和疾病的恢复。
